Spotlight On: Wraparound Services

This team will laugh often, require respectful communication from each other, laugh again.

This is the mission of the Smith* family’s Wraparound team. On a Monday evening, they all circle around the family’s kitchen table for a Child & Family Team Meeting, talking and joking like they’re about to share a meal together. They’re all here to support Ashley*, the Smiths’ youngest daughter who has battled anxiety, self-harm, disordered eating, a suicide attempt, and withdrawal from school, all within the past year. Chairs are pulled up, paper packets distributed, and the first question gets tossed into the mix like a beach ball: “What’s gone well this month?”

This strengths-based and positivity-based program has been embedded within A&C for a long time, catching some of the most severe youth cases. Though, Wraparound is bigger than Adult & Child. It’s an internationally-used model of care that embraces severely unstable kids, not letting go until they can stand on their own. Youths aged anywhere from 6-17 connect with this program through a multitude of referral sources: local psychiatrists, residential facilities, Department of Child Services, and any Adult and Child service line. A large majority of referrals come from our School Based service.

The service line breaks down like this: A&C has two Wrap teams, one in Johnson County, one in Marion. The Johnson team is the exclusive provider in their area, but Marion County has three other agencies providing Wrap: Midtown, Aspire, and Gallahue. But it’s never been a competition between providers in Marion County, all Wrap providers work together and collaborate out of our 603 E. Washington St. location, or did until just recently, (We miss you, Gallahue!) Each A&C team has a Leader, a Lead Clinician, a group of Facilitators, and an Access Coordinator who acts as a gatekeeper, making sure potential clients meet the criteria. Since Wraparound involves so many sources of support, the providing agency is constantly working with outside entities and independent providers to create the perfect social and supportive biome for a family to heal.

Elaine Trepanier, Marion County Lead Clinician and Wrap Facilitator, facilitates for the Smith family. Her job is to lead & manage the entire team through the entire process. Ashley’s team consists of Mom, Dad, Grandma, her sister, A&C Wrap Therapist Sophie Foster, and a Habilitation Provider, (to work on skills and interacting with the outside world) and a Family Support and Training Provider (who works with the parents and family to understand diagnoses and give parenting tips.) Giving a briefing on Ashley Smith’s case Elaine’s earnest admiration for this family shines through. “She hasn’t gone to school in a year, and she just started to go again one to two days a week, it’s brilliant.” she said. “She’s got such a great, sarcastic sense of humor, I love this child.”

“The coolest thing about Wrap, I think, is that it’s all based on family voice and choice,” said Lisa Kress, Wrap Team Leader for Johnson County. What this means is that the family gets to choose literally every person they work with throughout the process. Everyone who works in Wrap is certified through the Indiana Division of Mental Health and Addiction. Facilitators are employed through an agency, but there are many different types of independent professionals also certified in the Wrap process. Those individuals earn a spot on what’s called a “pick list.” This is a reference guide for families to look through providers and pick who they think might be right for them. A facilitator can set up interviews and meetings to help them choose. At any point, the family has the power to switch up their providers, agency people included. This helps them develop the best team possible and lets the clients wield more control over their recovery. Most teams consist of a therapist, a Habilitation Provider (Hab), and a Family Support and Training provider (FST). Other important people in the youth’s life can also join the team as natural supports. Ashley’s natural support on the team is her grandmother. She was the only family member Ashley let stay in the room while practicing her slam poetry piece after the CFT meeting. “And that’s the thing about Wrap,” said Elaine, “You get to be creative in ways other types of services don’t.” Built into her Plan of Care, Ashley attends salsa dancing lessons and Inner Beauty workshops, she writes slam poetry, she’s attended yoga sessions with Elaine & Hab, Tiffany. The Wrap team is essentially extended family you get to choose. It’s a path to healing you get to alter at any point. “It’s an in-depth process,” said Lisa Kress, “Lots of meetings, lots of past info. We build on what went well, we push you outside your comfort zone, but you have a team behind you and you’re never alone. I always say, ‘If you don’t like something, we can change it … When you remind people of that, you can see that sigh of relief.”

The strength of Wrap seems to be its strength-based philosophy. “We build on what’s gotten the family through tough times before,” said Elaine. Families coming into the program are struggling. They’ve suffered a lot. No one’s denying the fact that their problems have been significant. But the Wrap process often seems like a celebration, even during crisis. It’s almost a mindset: you celebrate every victory, you focus on what’s going right instead of what’s going wrong, you follow your passions, you discard things not meant for you. That mindset seems to spill into the staff as well. Every facilitator or provider witnesses the dramatic changes in these families every day, and can rattle off on cue cases with miraculous turnarounds.

In the Smith’s dining room, Elaine says to Ashley, “If you were trying to get into Wrap today, you would not meet the criteria,” noting how far she’s come since beginning the process in November. The entire meeting is full of a sense of buoyancy. Laughter punctuates the discussion of every new topic. Of course, there are many meetings where this is not the case, but the rhythm of Wrap is a heartbeat. It’s all-at-once intimate, compassionate, and fundamentally human.